Organization
PEDIATRIC NEUROPSYCHOLOGY SERVICES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVIDA GOLDMAN PH.D., L.P. (OWNER)
(952) 831-7400
Entity
Organization
Contact information
Practice address
7200 FRANCE AVE S, SUITE 128, EDINA, MN 55435-4300
(952) 831-7400
Mailing address
4120 AVONDALE ST, MINNETONKA, MN 55345-1805
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116883
HEALTHPARTNERS
MN
01
—
337G4PE
BLUE CROSS BLUE SHIELD
MN
01
—
61-90675
MEDICA
MN
Enumeration date
12/27/2005
Last updated
09/11/2025
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